State's Hep C probe nears completion

EXETER — State health officials are hopeful they are nearing a conclusion in the public health investigation into the Exeter Hospital hepatitis C outbreak.

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By Aaron Sanborn

seacoastonline.com

By Aaron Sanborn

Posted Dec. 7, 2012 at 2:00 AM

By Aaron Sanborn
Posted Dec. 7, 2012 at 2:00 AM

» Social News

EXETER — State health officials are hopeful they are nearing a conclusion in the public health investigation into the Exeter Hospital hepatitis C outbreak.

It's been more than a month since Merrimack Superior Court Judge Richard McNamara granted the state Department of Health and Human Services broad access to Exeter Hospital's medical record system. In that time, the hospital has cooperated with the state, and the state has reviewed the records of about 50 patients and has begun to view 30 additional records, according to Dr. Sharon Alroy-Preis, New Hampshire's epidemiologist.

"We've learned things from the records review that are important to our investigation but nothing that would require us to change the scope of it," Alroy-Preis said. "The investigation is still ongoing and that can change, but we're hopeful we can wrap it up soon."

Alroy-Preis estimated that it might take a few weeks to review the remaining 30 patient records.

A total of 32 Exeter Hospital patients connected to the hospital's cardiac catheterization lab have tested positive for the same strain of hepatitis C as alleged infector David Kwiatkowski. A large part of the state's ongoing investigation, including the state's request for broad access to the hospital's medical records, was to make sure the outbreak hadn't expanded to other portions of the hospital or to other patients, according to Alroy-Preis.

In addition to the cath lab, Kwiatkowski also had access to the hospital's main operating room and intensive care unit. There were 28 patients who had a past hepatitis C infection cleared by their immune system and in order to determine whether or not those patients contracted the disease from the hospital, the state needed to review those patients' medical histories to see whether they could have contracted the disease elsewhere.

"We hope 32 patients is the final number and that we don't find any more," Alroy-Preis said. "We're still waiting for some testing results from the Centers for Disease Control, so it's possible that number could still change, but we're hoping it won't."

Alroy-Preis said most of the remaining test results the state is waiting for are in relation to this summer's rapid testing clinics, where more than 3,000 patients were recommended for testing because they received treatment in Exeter Hospital's main operating rooms and intensive care unit between April 1, 2011, and May 25, 2012. Kwiatkowski had limited access to those areas during that time period.

Alroy-Preis cautioned that the investigation remains fluid and officials will take as long as they need.

"We want to wrap it up as efficiently and quickly as possible and we will once we get assurance that the public is safe and we did everything we needed to do to protect them," she said.

Kwiatkowski, 33, was arraigned early this week on 14 federal charges, including seven counts of tampering with a consumer product and seven counts of illegally obtaining drugs. Kwiatkowski pleaded not guilty to the charges and is currently scheduled to stand trial beginning the week of Feb. 5, 2013.

Prosecutors have described Kwiatkowski, who is infected with hepatitis C, as a "serial infector." He is accused of stealing syringes filled with fentanyl and then refilling the tainted syringes with saline. The syringes were then used on patients.

As a traveling technician, Kwiatkowski worked in at least 17 other hospitals in Michigan, New York, Pennsylvania, Maryland, Arizona, Kansas and Georgia from 2003 to 2011.

There have been six patients in Kansas who have been identified as being infected with the same strain of hepatitis C as Kwiatkowski and one in Maryland.

Kwiatkowski was reportedly involved in multiple suspicious incidents at other hospital jobs he worked at across the country and was fired from two previous hospital jobs in Pennsylvania and Arizona before coming to Exeter. In a 2010 incident in Arizona, Kwiatkowski was allegedly found unresponsive in a locker room with syringes and needles. Tests allegedly later showed he had cocaine and marijuana in his system. Because of the lack of criminal charges in these matters, they never appeared on a criminal background check.

This case has led to an outcry for a national registry for workers involved in patient care and for a requirement that health care providers report former employees whose actions pose risks to patient safety.